Ca­trin’s Long Way Back

THE MOUN­TAIN ROAD, THE FIERY CRASH AND THE MONTHS OF RE­COV­ERY THAT CHANGED A YOUNG WOMAN’S LIFE FOR­EVER

The fiery crash and months of re­cov­ery that changed a young woman’s life for­ever. ROBERT KIENER

This gap-year ex­pe­ri­ence had been Ca­trin’s first time liv­ing away from home and she was anx­ious to see her par­ents, Sara and Carl, both of whom were school­teach­ers, her brother, Robert, and her sis­ter, Mari. Although she had an in­de­pen­dent streak, she’d been home­sick and longed for her town of Wrex­ham, in north­ern Wales, where she’d grown up and gone to school.

Along with 50 other young sea­sonal work­ers, she had boarded a char­ter bus on April 16, 2013, at the re­sort for the 20-hour drive to the United King­dom. She sat di­rectly be­hind the bus driver, Mau­rice Wright­son, so she could take in as much of the Alps’ beau­ti­ful scenery as pos­si­ble.

The first stage of the trip—a de­scent last­ing 14 kilo­me­tres—had be­come world-fa­mous as one of the most gru­elling climbs of the Tour de France. At each of the route’s 21 hair­pin turns there was a plaque com­mem­o­rat­ing for­mer win­ners of this stage in the bi­cy­cle race.

Ca­trin Pugh was com­ing home. The bub­bly Welsh 19-year-old had just fin­ished a four-month con­tract work­ing as a wait­ress and cham­ber­maid at the ski re­sort of Alpe d’Huez, high in the French Alps. The pay was min­i­mal, but there was a bonus: she could ski for free on her days off.

As Wright­son ma­noeu­vred the bus, Ca­trin looked out on snow-capped peaks and sun-filled val­leys. Sud­denly the bus sped up after it turned onto the straight stretch of road be­fore bend 21, the last turn on the tor­tu­ous moun­tain route. “The brakes are gone!” shouted Wright­son as the bus con­tin­ued to gain speed, headed for a 90-me­tre drop-off. Ter­ri­fied, Ca­trin looked out her win­dow at the sheer drop to the ravine be­low and thought, I’m go­ing to die! We are all go­ing to die!

Wright­son vi­o­lently turned the bus to the right, des­per­ately hop­ing to stop it by crash­ing into the side of the moun­tain in­stead of al­low­ing it to plunge into the val­ley. At the same time, Ca­trin’s seat­mate, Shaun Ste­wart, cra­dled her in a head­lock. “Brace your­self!” he shouted, telling her to wedge her feet against the seat’s sup­ports to keep from fly­ing out through the bus’s wind­shield.

The bus crashed into the side of the boul­der-strewn moun­tain with such a force that many of the pas­sen­gers were thrown onto the floor. The sound of shat­ter­ing glass and twist­ing metal was deaf­en­ing. Bat­tered and dazed, most pas­sen­gers clam­bered out of the bus’s emer­gency exit or jumped out win­dows. Then, in an in­stant, the fuel tank in the front of the bus ex­ploded and set Wright­son on fire.

Ca­trin fell to the floor. As Wright­son shouted for help, the flames spread along the floor to her and she stood up, in shock. Within sec­onds, she was en­gulfed in fire. Ste­wart rushed to Ca­trin and pulled her off the bus. He and oth­ers smoth­ered the flames that were burn­ing off her clothes and singe­ing most of her skin.

CA­TRIN DIDN’T STOP SCREAM­ING UN­TIL THEY PUT AN OXY­GEN MASK ON HER. THEN SHE PASSED OUT.

Ly­ing on the side of the road, Ca­trin raised her right arm and was hor­ri­fied to see her mot­tled, burnt skin. Her hands and arms were raw and blood­ied. She started scream­ing. The pain was ex­cru­ci­at­ing—it was as if she were be­ing stung by hun­dreds of hor­nets. Pas­sen­gers ripped off their shirts to cra­dle her head and stop her bleed­ing. Some held a sheet over her to shield her from the sun.

Paramedics even­tu­ally ar­rived; four pas­sen­gers had se­ri­ous in­juries and Mau­rice Wright­son died on the scene.

Ca­trin didn’t stop scream­ing un­til they put an oxy­gen mask on her face. Then she passed out.

The mes­sage on Sara Pugh’s phone from her hus­band, Carl, was short: “Come home. Quickly. Noth­ing to worry about.” How­ever, when she ar­rived at the cou­ple’s four-bed­room house, Carl’s face told a dif­fer­ent story. “There’s been an ac­ci­dent,” he told Sara. “It’s Ca­trin.”

He ex­plained that he’d got­ten a call from France but didn’t know more than that. He’d been given the num­ber of a hos­pi­tal in Greno­ble to call for more in­for­ma­tion.

A he­li­copter air­lifted Ca­trin to the Univer­sity Hos­pi­tal in Greno­ble, where doc­tors dis­cov­ered she had burns over 96 per cent of her body. Only her scalp, a small part of her face and the soles of her feet were un­touched. They de­cided to trans­fer her to a spe­cial­ist burn unit at a larger hos­pi­tal in Lyon, an hour away.

After fi­nally reach­ing the hos­pi­tal in Lyon by tele­phone, Carl learned that Ca­trin’s burns were ex­tremely se­vere. “It is very se­ri­ous,” a French

doc­tor told Carl. “It would be best if you came right away.”

Sara flew to Lyon the next morn­ing. Carl, who was us­ing a wheel­chair after a re­cent hip-re­place­ment surgery, fol­lowed the next day with his brother-in-law.

In the nearly 24 hours since the ac­ci­dent, Ca­trin’s se­vere burns had rav­aged her im­mune sys­tem and threat­ened mul­ti­ple or­gan fail­ure. To spare her from pain, doc­tors had in­duced a coma and placed her on a ven­ti­la­tor.

At the hos­pi­tal in Lyon, Sara met with Ca­trin’s head doc­tor and asked him, “Do you sur­vive some­thing like this?” The doc­tor paused, looked down at the floor, then met her gaze and an­swered gen­tly, “A small—a very, very small—num­ber of peo­ple do.”

Be­fore Sara walked into Ca­trin’s room in the hos­pi­tal’s in­ten­sive care depart­ment, she steeled her­self. I won’t cry. I have to be brave, she thought. Then she saw Ca­trin, un­con­scious and teth­ered to a wall of blink­ing, whirring ma­chines. A bank of heat lamps glowed red above her bed to keep her warm. Her body was com­pletely swathed in a ther­mal blan­ket and thick white ban­dages, ex­cept for half her face.

Sara nearly broke down. She wanted to hug Ca­trin but was afraid of hurt­ing her. She swal­lowed hard and told her­self to be pos­i­tive. As the ven­ti­la­tor whirred rhyth­mi­cally, she looked past what she could see of Ca­trin’s black and red burnt, swollen face and con­soled her­self by think­ing, She has her teeth, her eye­brows and her eye­lashes. She’s still my Cat.

CA­TRIN WAS AL­WAYS PUSH­ING HER­SELF. “I CAN DO THAT” WAS A RE­CUR­RING RE­FRAIN WITH HER. AND SHE DID.

She reached out and touched Ca­trin’s ban­daged arm. “Cat, it’s Mum, I am right here,” she told her. “We are go­ing to get you bet­ter,” even though she didn’t think Ca­trin would sur­vive more than a few days.

The next evening, after Carl had ar­rived and had seen Ca­trin, he and Sara tried to pre­pare for the worst. But Carl couldn’t bear the thought of los­ing his “Princess.” Be­sides, Ca­trin had a re­silience that had served her well through­out her 19 years. “Strong willed” is how he and Sara had of­ten

de­scribed her. As Carl once ex­plained, “She has never been back­ward about com­ing for­ward.”

Ca­trin started go­ing to dance school when she was just eight years old and loved get­ting on a stage to act and sing. (Her dream was to en­rol in a the­atre school in Lon­don.) On fam­ily va­ca­tions she would copy a ho­tel’s fla­menco dancers and dance around the ta­bles. She was the one who loved get­ting out the cam­era at fam­ily events and urg­ing ev­ery­one to “Give us a smile!”

She was al­ways push­ing her­self. She started work­ing as a wait­ress in the lo­cal pub at just 16. When she chose to do her A-lev­els in math, no one could per­suade her to try some­thing less de­mand­ing. “I can do that” was a re­cur­ring re­frain with her. And she did.

Ian James, one of the United King­dom’s most ac­com­plished burn spe­cial­ists, had just fin­ished lec­tur­ing to physi­cians and med­i­cal stu­dents in Athens, Greece, when he read a news story about Ca­trin’s ac­ci­dent. The plas­tic sur­geon su­per­vised Mersey Re­gional Burns Unit at Liver­pool’s Whis­ton Hos­pi­tal, one of the most pres­ti­gious burn cen­tres in the U.K. The doc­tors in France are go­ing to have a tough time, he thought. I don’t think she can sur­vive with 96 per cent burns.

Un­be­knownst to James, the U.K.based com­pany that had hired Ca­trin to work in France had been in fran­tic dis­cus­sions with French and Bri­tish doc­tors about the pos­si­bil­ity of fly­ing Ca­trin to Eng­land for treat­ment. A bed was avail­able at Whis­ton, her best hope.

Five days after her ac­ci­dent, an elite team of sur­geons, nurses, anes­the­si­ol­o­gists and med­i­cal tech­ni­cians at

FOR MORE THAN A WEEK, CA­TRIN DRIFTED IN AND OUT OF CON­SCIOUS­NESS.

THEN ON DAY 100, SHE FI­NALLY MOVED.

Whis­ton op­er­ated on Ca­trin in a de­ter­mined ef­fort to save her life. First, they scraped off her dead skin be­cause it can eas­ily be­come in­fected. Pa­tients who don’t sur­vive such large burns usu­ally die from an in­fec­tion of the un­healed wounds, so keep­ing them clean was a pri­or­ity.

They took a small sam­ple of un­burned skin from her scalp and sent it to a lab­o­ra­tory to be grown, or cul­tured, for fu­ture graft­ing. Then they cov­ered more than 40 per cent of Ca­trin’s raw tis­sue with ca­daver skin

from Liver­pool’s na­tional skin bank to help pre­vent in­fec­tion, pre­serve body tem­per­a­ture and pro­mote heal­ing. Even­tu­ally, the donor skin would be re­placed by new skin grafts.

Ca­trin sur­vived the five­hour op­er­a­tion, but when James met with Sara and Carl he was blunt: her chances were “one in 1,000.” In­fec­tion was a threat; James’s team needed to change Ca­trin’s an­ti­sep­tic dress­ings in threeto four-hour ses­sions, once or twice ev­ery day. Be­cause her or­gans had been so da­m­aged by the trauma, the threat of kid­ney fail­ure or heart at­tack was ever-present. James de­scribed the med­i­cal pro­ce­dures as “mil­i­tary team­work.” Ev­ery day was a bat­tle.

One week went by. Then an­other. Time and again, Ca­trin was op­er­ated on as sur­geons har­vested and grafted new skin. At three weeks, James ad­mit­ted he was sur­prised. He told Carl and Sara that, mirac­u­lously, the odds of Ca­trin’s sur­vival had im­proved to one in 100.

For three months, Ca­trin re­mained locked in a coma. Ev­ery day was a bat­tle, but her young body fought off in­fec­tion after in­fec­tion and with­stood ex­ten­sive skin grafts and ma­jor op­er­a­tions. To pre­vent her new skin from stiff­en­ing, phys­io­ther­a­pists “ex­er­cised” her arms and legs twice a day, bend­ing and ex­tend­ing them.

Then, one day, James told Sara and Carl that their daugh­ter, the girl who was so fond of say­ing “I can do that” had beaten nearly im­pos­si­ble odds: “I’ve never seen any­one as badly burned as Ca­trin sur­vive,” James said. It was time to bring her back.

For more than a week, as she was weaned off the cock­tail of drugs that se­dated her, Ca­trin drifted in and out of con­scious­ness. Then, on day 100, she fi­nally moved.

Be­cause Ca­trin had been co­matose and im­mo­bile for months, her mus­cles had at­ro­phied. She had lost 30 kilo­grams, nearly half her body weight.

Ca­trin was too weak to hold her head up and would have to re­learn to stand and then walk. She had more than a year of phys­io­ther­apy ahead of her.

The ma­jor burns had de­stroyed tis­sue and caused neu­ropa­thy, a con­di­tion in which the nerves vir­tu­ally stop work­ing. While her nerves be­gan to re­grow and re­cover, she ex­pe­ri­enced hor­ri­ble pain. Painkillers helped some­what, but Ca­trin dreaded hav­ing her dress­ings changed. In­evitably, as care­fully as her nurses re­moved her dress­ings, they would peel away some raw skin and Ca­trin would scream.

Then there was her ap­pear­ance: most of her face had been badly burned and she had lost part of an ear and the tips of sev­eral fin­gers. Doc­tors had shaved off the lux­u­ri­ous long hair she had been so proud of; they would scrape her head for skin grafts six times while she was in the hos­pi­tal.

Dur­ing her thrice-weekly baths, which re­quired 10 peo­ple to hold and bathe her in an over­sized tub, Ca­trin could see her body. She was hor­ri­fied; it looked like a scarred checker­board of raw pinks and blood­ied reds. No one will ever love me, she thought to her­self. Later, as she drifted off to sleep, she told Sara, “It would have been eas­ier if I had died.”

But she still hadn’t seen her face or her shaved head.

Don­nas Wilkin­son, a 30-year vet­eran nurse who had been su­per­vis­ing Ca­trin’s re­cov­ery, re­al­ized it was time to let the teen see her­self when she over­heard her telling her mother, “I can’t wait to sham­poo my hair again.” Wilkin­son went to grab a hand mir­ror.

Si­lence. Then screams. Then tears. “No! No!” Ca­trin cried. “I look like an

CA­TRIN HAD HAD ENOUGH. THE PAIN, HER AP­PEAR­ANCE AND THE FRUS­TRA­TION OF LEARN­ING TO WALK WERE TOO MUCH.

alien. It’s not fair.” No mat­ter how much Wilkin­son tried to con­sole her, ex­plain­ing that her hair would grow back and she’d look so much bet­ter some­day, Ca­trin kept cry­ing.

Ca­trin had had enough. The pain, the heart­break of her ap­pear­ance, the frus­tra­tion of hav­ing to learn to walk and feed her­self were too much. “I won’t,” be­came her an­swer to the sim­plest re­quest.

James and Wilkin­son had seen other burn pa­tients sink into de­pres­sion

and they knew what they had to do. “We are go­ing to push Ca­trin,” James told Sara and Carl. “She may hate us, but that’s okay.”

They went on the of­fen­sive. When Ca­trin re­fused to do her phys­io­ther­apy, James told her firmly, “If you ever want to use your hands again, you have to ex­er­cise them now. If you want to dance and per­form again, you need to start try­ing.”

Ca­trin burst into tears. James im­me­di­ately asked her why she was cry­ing. She an­swered, “Be­cause you said I will never dance again.”

“No,” James an­swered. “What I said was that you would never dance again if you don’t try.”

His ap­proach be­gan work­ing. Ca­trin pushed through the pain of phys­io­ther­apy by think­ing, I’ll show them.

One day, she asked a nurse to help her take a selfie to post on In­sta­gram. I know I look hor­ri­ble but I’ll show the world! Ca­trin thought. The pic­ture was of her with a shaved, scabbed head, a feed­ing tube hang­ing from her nose and a mas­sive smile. The cap­tion read, “Get­ting there.”

To help pre­vent per­ma­nent scar­ring, Ca­trin needed to wear pres­sure gar­ments and a cus­tom-moulded plas­tic face mask 23 hours a day. When she be­gan re­sist­ing, Wilkin­son asked 31-year-old Heather Simp­son, who had been burned over 75 per cent of her body, to visit Ca­trin.

As Simp­son stood at her bed­side, Ca­trin pep­pered her with ques­tions: “Will it hurt for­ever?” (It will be man­age­able.) “Do you live on your own?” (I am mar­ried.) “Do you have a job?” (I went to univer­sity and now have a govern­ment job.)

SHE’D BEEN HOME FOR JUST UN­DER A YEAR WHEN CA­TRIN TOLD HER PAR­ENTS

SHE WANTED TO SKI AGAIN.

Simp­son also gave Ca­trin some stern ad­vice: “You can play the vic­tim, but peo­ple will even­tu­ally get bored with that. It’s up to you.”

Ca­trin con­fessed that she hated wear­ing her pres­sure gar­ments. Simp­son said, “So did I.” She took off her jacket and showed Ca­trin her right arm, which had healed nicely. Then she showed her left, which was badly scarred. “Guess which arm I didn’t wear my pres­sure gar­ment on,” said Simp­son.

The visit was what Ca­trin needed. She co-op­er­ated tire­lessly with her

phys­io­ther­a­pists. And on De­cem­ber 7, 2013, after nearly eight months in the hos­pi­tal, she went home to con­tinue her re­cov­ery. Although she couldn’t feed her­self, clean her­self or walk un­aided, she worked in the hopes of one day re­gain­ing her in­de­pen­dence.

Three months later, she re­turned to Whis­ton hos­pi­tal for a checkup. James had just fin­ished check­ing her dress­ings and Ca­trin was sit­ting on a bed when he said, “Walk to me, Ca­trin.”

“I can’t,” she an­swered him. “Not by my­self.”

“Give it a go,” he said. “I’ll catch you if you fall.”

She didn’t want to dis­ap­point James. Try, she told her­self. Ca­trin gin­gerly walked one step, then an­other. There was pain, but it was man­age­able. She man­aged three or four more be­fore fall­ing into James’s arms.

Ca­trin be­gan walk­ing, then run­ning on a tread­mill, then jog­ging out­doors. She had also re­gained the use of her arms and was controlling her pain with over-the-counter reme­dies. Her hair had grown back, and she no longer needed to wear her face mask and tight­fit­ting pres­sure gar­ments.

By the time she’d been home for just un­der a year and was walk­ing unas­sisted, she told her par­ents she wanted to ski again— and she wanted to go back to the French Alps. Sara and Carl couldn’t be­lieve their ears. How would Ca­trin cope with re­turn­ing to the scene of her ac­ci­dent? But they both knew their daugh­ter well enough not to doubt her. Ca­trin be­gan tak­ing lessons with a char­ity for dis­abled skiers, us­ing adapted skis (laugh­ing, she called it “my walker on skis”) to glide down an ar­ti­fi­cial “dry” ski slope in Wales.

On De­cem­ber 23, 2014, Ca­trin, her fam­ily and friends re­turned to Val Thorens, the high­est ski re­sort in

Eu­rope. The fam­ily had come here for more than a decade, and this was where Ca­trin, Robert and Mari had learned to ski. But this year was dif­fer­ent; a tele­vi­sion crew ac­com­pa­nied the fam­ily to cover her re­turn to the slopes.

Un­der an im­pos­si­bly blue sky, Ca­trin was helped into her skis. She dou­blechecked her gog­gles and ski hel­met. She con­fessed to the re­porter, “I have but­ter­flies in my stom­ach.” As the cam­eras rolled, she took off, ski­ing slowly but steadily down one of the gen­tler slopes.

As she sped up, some­thing ex­tra­or­di­nary hap­pened. Her brother, sis­ter and friends formed a di­a­mond-shaped mov­ing bar­rier around her, pro­tect­ing her as she glided down the slope. Ca­trin was thrilled. I’m free, she thought as she once again felt the wind against her skin and her legs re­spond­ing to the snow. She wasn’t speed­ing down the slope as she had years be­fore, but this was still a vic­tory.

Be­fore she slowed to a stop at the bot­tom she spot­ted her fa­ther, wait­ing with his arms out­spread. Tears were stream­ing down Carl’s face. His daugh­ter had de­feated im­pos­si­ble odds. Carl hugged her, whis­per­ing, “You’re back, Ca­trin. You did it!”

For the past four years, Ca­trin has trav­elled across the U.K., speak­ing to stu­dents and other groups. She tells them her story—all about how she re­cov­ered from her in­juries, the need to tri­umph over ad­ver­sity, be­com­ing “bet­ter, not bit­ter” and the im­por­tance of main­tain­ing a good body im­age, no mat­ter how scarred one may be.

The wreck­age at the side of the moun­tain where the bus car­ry­ing Ca­trin Pugh and other sea­sonal work­ers crashed and burned.

Mari, Sara and Carl Pugh with Ca­trin, a few months after she was brought to the hos­pi­tal.